Speculum



Patented Man i9, 1529.

fears nninnonn n; WAPPLER, or YoNKnRs,` NEW Yoan.

Ammerlaan ne@ october 3o, 192e.' serial No. 145,130.

My present invention relates generally 5to surgical instruments, and has particular reference to specula.

Although l have illustrated and -shall -hereinafter `describe my invention as applied to an endoscope or similar instrument, nevertheless it will be understood that as to certain phases of my invention an application of this character is not essential.

'There has always been considerable diiiiculty in making it possible for an operator to employ surgical instruments with an endoscope or similar device kand to simultaneously observe the instrument in operation. The principal cause of the `d'iiiicultylies in the inconvenient location, for apurpose ofthis character, of the human eyeends of endoscopes and similar devices are of necessity rather small, and the head of an operator consequently interferes in an annoy-ing manner with the employment of an instrument Where simultaneous observation is attempted. f

Even Where devices have'been employed which shift or transfer the optical axisy to a point spaced from the end ofthe tube,sim'1lar diiiiculties, complicated by the requirement that the visibility beV erect and uninverted have arise l have found that Aany arrangement whereby the necessary positioning of the operators head is such that his vision will be directed along aline parallel to the tube axis is beset withr the furtherdifiiculty that the instrument must be controlled from va point alongside of the head. A position of thisv character is extremely uncomfortable and not conductive to accurate and delicate control. Y Y

lt is therefore one object of the present invention to provide a device which permits the employment of an operating instrument 1n conjunction With an endoscopic or similar tube. and which permits simultaneous observation through the tube in a manner which is devoid of the difficulties illustrated by those specified. More particularly,- it is an object vof the invention to provide a devicerivhose constituent parts are so arranged and con' structed Vthat a Ydirect and uninverted view is rendered possible, -Wlnle 'at the Sametime the The exposed relative positions'of the operator-,7s head, `the instrument, and the y-tuloe are such as 'tolrender y the simultaneous vision convenient and unannoying. y e i Y p Another object of the invention is to provide the device in a formvivhieh permits 'the provision of the sight arrangement the form .of a removablel attachment, thereby making it possible 'to lachieve fthe 'advantages of my invention .in conjunction with endoscop-ic tubes of any character and ipfartimilarly of' lthe largeY number` which v'are already in Y My invention embodies features-Which `:per-'.- mit thersi'multaneous and independent fob; 65 servation by more thanY onev person ofgcertain steps :offsurgical operation, while at the same time permitting normal .utilization of operat-l ing instruments.

@inzefeature Vof the invention lies in prov-id ing anA arrangement' which leaves the normal size of *the passageway through the endoscope, and the normally accessible open end thereof, practically unaffected and unimpaired.. My invention .contemplates the arrangement withv an open-.ended endoscopic tube ofafsiglit device vWhich is .disposed Wholly eXteriorly of the endoscopicv tube, Which is entirelyy selfcontained and which vdoesnotdepend for its 1 proper functioning upon any velements `which s0 are positioned-Within vthe tube; andin this Way, theslight device,.Wlien provided in the form of a detachable unit, lmay be advantageously employed with anyfford'inary typeof,` tube. f i i lt is Aa `featurezof my invention to `provide a device which produces an imageV in aplane` which is non-perpendicular Vto the axis of the tube, thereby rendering it possible 'for the operator to lookin a direction which forms an angle to theY tube axis. InV this Way, his head may be entirely Withdrawn from 4any positions wherein it may either interfere with the employment offinstruments, .be 'subjected to unpleasant dischargesfrom the tube, or render the Vaccurate control of .the instruments dificult 1 f Y Another feature .of the invention lies' `in providing the sight device in a str tural form which necessitatesthe linterpositi'on Vof only 100'/ tubular element axis.

constructed as-to permit the interposition of only an extreme edge portion thereof in the path of the light rays to effect the complete collation of all the light rays necessary to thereafter produce the desired image.

A preferred form of the invention contemplates the provision of an attachinp` portion such as a collar, this portion being` mountable v ments will be insertable through the end 15 or disposable upon the end of an endoscopic tub-e, and a sight device or optical instrument in the form 'of a tubular element mounted uponthe' collar and disposed atan angle toV the tube axis.. The nature of myinvention is vrsuch that the eyepiece at the endof the tubular element will be arranged in a plane which Vis non-perpendicular to the'tube axis and which' may in fact be perpendicular to the A modified form of the invention, particularly ,Where it is desired to utilize certain feav tures thereof forinstruction purposes, em-

bodies a. second optical instrument in the form of a telescope or similar magnifying instrument ywhereby it is possible to interpose elements in an out-of-focus manner .in `the path of the telescope Without iinpairing the vision therethrough. 1 l 1 Other features of the invention lie in the particular arrangement of parts andthe structural natures of the sight devices referred to. In general, it is'an object ofthe inventionito provide device which is ei:- tremely simple of .fc-onstruction, hence inexpensive vfrom the standpoint of manufacture and easy to manipulate; which enables the provision of an easily attachable and detachable device from an endoscope or speculum of ordinary characteristics; and ivhicli is extremely eiiicient in fulfilling; the yfunctions contemplated.-

For the .attainment of the foregoingl objects and such other objects as may hereinafter Vappear. or be pointed'out, l have illustrated tivo forms of my invention in the.

companyini;` dra-Wings in Whichmy invention;

Y Fig@ is an enlarged plan vieiv, in cross section along` the line 2-2 of Fig. 1, showing;` the essential. elements of my device; Fig. 3 a` plan vieiv of a modification and Fig. Llis an end view-of Fing.' 3,this view being taken in the direction of thetube axis. Referring` now to theidraivings, and particularly to Fig. 1, it will be observed that i have shown my invention as applied to an instrument Which comprises an endoscopic tube-,10 havinga 'forward portion 11 provided with a fenestralopening (not shown) and provided Wit-ha rear portion. denoted generally by the reference numeral 12. Therear portion may embody numerous instrumentalities and connections, depending upon the particular functions of the instrument, such s as the pet-cocks 13, the electrical terminal 111,

etc.; but in any event, it is contemplated that the instrument With which my invention Will be employed ivill embody an end 15 which will serve as source of association between the' tube proper and the sight device or devices of 'the invention. y

rIt is contemplated that surgical instruone which may be positioned Within al body cavity for the purpose of utilizing such operating instruments, and not for the sole purpost of exan'iining the interior of the cavity. However, it is ofcourse possible to employ a holloii7 .tube ofl this character for purposes of mere inspection as Well as forA purposes of operation. Y

My invention contemplates the provision of an arrangement which Will permit observation to take-place and be sustained even duringl the periods when operatinginstruments are being employed and to permit such'observation to be partaken of in a manner which doesnot necessitate the positioning of the observers head in any inconvenient or unpleasant manner. Furthermore, the arrangement is such that observation may be had by more than one person during the o} ierating proceinp; an` attaching` portion in the form of a spring collar or clip 16 and a sight device 17 associated with vthe collarlG. T he sight device isa substantially tubular elementlivhich' may be rectangular in cross-section, which mayhave an eyepiece 18 associated Ywith its outer end, and 'which is siinably associated with the collar 16 by meansfo'f a vstrut 19, an adjustable screw 20, and an arm from the collar 16.

Reference to Figure 1Q vrill shoiv more clearly the structural nature o-f the sight device 17. V rangement is such as to dispose its axis at an angle to the axis of the tube 10, and that the eyepiece 18 is arranged upon its outer end iii` a plane substantially perpendicular It willbe observed that its ar-` lOO` 2l extending to the axis of the element 17. rlissocia ed y with the inner end oftheelement 17 .a double reflecting prV m22 ivhose rear ivall 23 is substantially perpendicular to the airisofY the element 17, Whose side walls fit snugly within the element'l, and -Whose forwardA V23, The walls of the element 17 are 'suitably beveled at .their inner ends so to .contorni to the exposed t-acerfi .of the erism `22.

An arrangement of this character ren-ders it possibie to collecte-nd tra smit all the iight rays emanating't 1om the endoscopic tube by simply inserting `the extreme end of the prifllm 22 into the path of these rays. The latte-r lWill encounter tiret theeXposed fac oit the prism7 will pass through this fa ce, and strike the rear Wall ot the prism.; they will then be reflected `to the forw rd tace 24 and will strike the latter at an angle which will cause their re-retleetion by internal reflection in aY Idirection -ivhich sends them outwardly thro-ugh the tube li'. .At the end of the latter there may be provided a plain piece of glass 25 forming With the cup-shaped device illus trated the cen'iplote eyepiece 18.

The double reiiecting properties of the prism 99 wiil cause the image -transmitted thereby to be erect and uninvertcd, and it will be observed that thisiniage is produced in a plane indicated roughly by the dotted line fothis plane forming an angle less .than 9.00 with the artis of 'the tube l0. It is the provision .of the erect image in a plane .ot this character which results in the advantageous features of the invention; and the reason 'for this th-atthe image may be observed by directing the line ot sight ot the human eye in a direction perpendicular to this piane, i. e., in the direction of the 'airis ot the element 17 as contradistinguished from Ya directiony which is eubstantialiy-parallel to the axis ot the tube l0.

By virtue or" the very slight amount of the' prism 22 which must be interposed in the path of the light rays emerging from the tube l0 in'order to produce t ie desired image referred to5 .the opening at the exposed eno of the endoscopic tube is lett practically unobstructed. Further here, the yarrangement of the sight device is such that it is entirely self-contained and does not depend for its functioning lupon any portions Within thev tube'lO. In this .Way7 the full cross-sectional size otl the passageway throiwh the tube l0 vis .lett available for 'operating instruments which may be ,inserted and remevedivith ordinary tacilitu through 'the open end.

For illustratiif'e purposes., i have shown the outer end ot' an instrument 2? extending into the tube i() 'tor the purpose off pe forming);

certain operations at the inner end V1i. For the salie oi clearness, the device has been illustrated in a manner which renders the instrument 2i' operable and controliable by the left hand ot an operator having his'eye at the eyepiece 18,v lalthough it will be understood that by merely inverting the instrument, or the sight device l?, the instrument 27 Would .be

manipulable by an operators right hand.V it willbe obvious that an operator having, let usV say, his left eye at the eyepiece 18 ot Fig. l would be able to manipulate the instrument 2li' with ,great ease.' because ofthe fact thatt-he instrument 1s m front of him land not alongside .of hishead.' F urthermore,.it'V

will be obvious that his head Will be entirely out ofthe Way .and ywill not rn any Way intertere with or render .ditli'cult the proper oon? y trol or" the instrument 2?. `sind it Willgalso be obvious that direct vision may be had through thetube ls() by astudent 'or a secon-d" observer if such addedobservationiis desired, in Figs. 8 and 4 I have illustrated a modication which will facilitate the observation by two parties during the use of the operating instruments. In this embodiment, thelattaching collar QSisof a .character vto bel clamped over the end l5 by means of 'a Wing nut 29, The structural nature of the' device 17', is

slidht'ly ditterent from that oi the devicev ,117,-

although essentiallythe same. Carried by the collar 28 is an additional axial arm .3.0 upon Whose outer end is mounted an optical device in the form .ot a telescope 3l, I haveshoivn this device in .theforni of a cylindrical element having a convex lens 32 at its tolwvardv lend ,and having .telescopically adjustable components 33 and 34 for permitting the' device to be Vfocused. i The entiredevice is ad-` jus'tably mounted upon the arm 30., and l have illustratively shown a supporting bracket having an openingin its outer end through which the arm 30 projects, the latter being provided with a tightening knob .36V whichl will position the bracket 35 in any radial posi;v tionivith respect to the arm 30.

It will be observed that the `telescope 3l is spacedfrom the endv of the endoscopic tube and that its axis is arranged parallel tothe axiso' the endoscope. The nature of the mounting 3() permitsthe telescope to be adr justed into a plurality ofpositionsparallel to the position shoWn,;i. e.rparallel lto the axis ofthe endoscope The optical nature of the telescope permitsvisibility therethrough to remain unimpaired even in adjusted posi-V tions other than a position coneentic" withv the endoscopic tube 10.*Asa metterei-fact, thebraclet 35 may be swung through approxeoY imately 90 Without having the {v'isibility' d through the telescope impaired.` Thus, referrin'gto Fig. et, the telescope has beenoi set tothe left, yet observation will bepossible therethrough ot the full enest-ral opening.

r.Qhe optical nature oi the telescope basan addedadvantage 1n the present instance because o5 the fact that :when focused for the.

ifenestral opening' all objects or elements di-` rectly 'in front of the telescope, such asthe interposed tip of the element 17", Will vbe out rof'focus and Will therefore have no .effect ypath of unpleasant discharges, While a 'ond observer or viccl' is such that only its extreme end portion proiects across a 'fractional portion of the open end of the tube 10 5' and the nature of the device 31 is such as to permitk displacement thereof` (Without iinpairing visibility therethrough) sudiciently to permit tree access to the end of the endoscope.` Thus, tl e Work.

Where desired, additional sight devices similar to the device 17 may be yprovided so as vto permit morethan one additional person to have observation.

It Will thus be observed that l have shown a device which is highlyeliicient, yet simple or' construction. lts arrangement and coni attacha'ble 'and Y detachable' unit.

ltions Will be perlorniable in a manner I ing these devices upon will vary struction Vrenc ers it possible to provide the sight portion thereof in the torni oi a readily7 y'lhe l device also Will be oi extreme benefit both to the medical profession and to mankind in general for the reason that operations, regardless et character, may be performed under sustained observation, Furthermore, the operais not an inconvenience and source of ani-.iov-v ance to the operator and .which Vivilltherefore, result in better vand more accurate operative steps.

Many of the details herein described for Jthe v purpose otexplaininn the nature of n y invention may be altered by those slrilled in the art fithout departing trom the spirit and scopeoi the invention. Thus, the sight de-V Y vices may be arranged `and constructed so ang esi'roni the end et The inanner or" mountthe endoscopic tube The enact to project at varying the endoscopic tube.

to suit requirements structural nature ot the sight devices need not necessarily be depicted in the draivin Other details et constructioninay be similar lyfvaried to suit varying requirements, it is therefore intended that these details, as theyinay appear in the appended claims, 'be

interpreted as illustrative and not in a limitin;T sense. l

Llilaving thus described my `invention and illustrated use, what l claim as new and desire to secure by Letters Patent 1. Ina ,device oi' the actor described,

an endoscopic tube havingk an open end tor the passage oi' operating instrument through the tube, andv means tor permitting an operator 'to look through the tube during the employment of jsaid instrument, said means comprising a sight Adevice associated which vdirected through s With the tube in a` manner which leaves said opening accessible, and said means being arranged and constructedto form a final image oi the tube interior in a plane forming an angle other than 90O to the tube axis, whereby the observing operators head Will not interiere With the employment of said instrument. i y y 2. ln aV device ol the character described, an endoscopic tube having an open end for the passage Y i through the tube, a sight device associated with the tube for permitting an operator to look through the tube during the employment oi said instrument, l'said device comprising a hollow element having a double reflecting prism at one end and said end being so positioned that the light rays einanatingv from the tube i l be directed through said element by said prism, whereby an erect image ot the tube interiorivill be visible to an operator looking directly into said holleiv clement.

oi' an operating instrun'ientV 3. ln a device'of the character described,

an. endoscopic tube having an open end vfor the passage 'of an operating instrument through the tube, and a sight'device associy ated With the tube 'for permitting an operator to lool; through the tube during theemployment of said instrument, said device compris ing a tubular element extending at anV angle aivayicroni saidopcn end and having a lightreceiving prism arranged in its inner Vend, said inner end being so positioned that the light rays emana from the tube will be id element by said prism.

' Asa removable attachment for an endo-` scopic tube having an opening for the pasL sage ot an operating instrument through the tube, a sight devicecomprising a tubular element having an eyepiece at one end arranged ysubstantially perpendicularly to said element-,and having a prism atthe opposite end arranged and constructed in 'a manner which permits an edgep'ortion thereof to collect and transmit the rays remerging from the endo.

scopic 'tube through said element to the eyepiece. f i

5. fis a removable attachment for an. endoscopic tube having` opening "for the pas- Old sage of an operating instrument through the tube, sight device comprising tubular eleinent having an eyepiece at one end and arfranged substantially perpendicularly to said element, and having a double reilecting prism' at its other end, said prism being arranged and constructed in a manner which permits edge portionthereo-to collect and transmit the rays emerging from the endoscopie tube through said element to the eye piece,

whereby said prism will produce an 'erect andl uninverted image which Vwill be visible through said eyepiece.y v

6. is a removable attachmentior an endoscopic tube,` a sight devi-cev comprising an attaching portion adapted to beA applied to the end of the endoscopic tube, and a tubular element carried by sai d attacl'i'ingportion and 'Xtend'ing at an angle from said tube end, said tubular elementV having an eyepiece at its outerend arranged in a pl'aiie substantially perpendicular to the axisot said element, and having optical means associated With its inner end for rendering an erect image of lthe tube interior visible through said eyepiece.

7. iis a removable attachment for an enj' doscopic tube, a sight device comprising an attaching portion adapted to be applied to the end of theV endoscopic tube, and a tubular element carried by said attaching portion and extending at an angle from said tube end. said tubular element having an eyepiece at its outer end arranged in a plane substantially perpendicular to the axis ot said element. and having optical means associated with its inner end for rendering an erect image of the tube interior visible through said eyepiece, said optical means comprising a prism having an inner tace parallel to the eyepiece and an outer face forming an angle therewith.

8. ln a device or" the character described, an endoscopic tube having an open end for insertion of an operating instrument, anda] sight device associated With said end and comprising a tubular element extending at an angle from said end, said element being arranged and constructed to project .only a portion of its inner end across said openend, thereby leaving the major portion of said open end accessible, and optical means asso-V ciated with said inner end for collecting the light rays'emerging ironiqthe endoscopic tube and transmitting them in an erect manner through said element.

9. ln a device of the character described, an endoscopic tube having an open end'for insertion an operating iiistrun'ient, and a sight device associated With said end and comprising a tubular element extending at an angle from said end, said element being arranged and constructed to project only a pcrtion of its inner end'across said open end, thereby leaving the major portion of said open end accessible, and optical means associated with said inner end'for collecting the light rays emerging from the endoscopic tube and transmitting them in an erect manner through said element, said means comprising a double reflecting prism having an attenuated edge portion arranged in the path ot said light rays. j

l0. The combination with an endoscopic tube, of a plurality of independent sight devices associated therewith in a manner which permits simultaneous observation into the tube through each thereof, one of said devicesvconiprising a telescope adjustable to- Ward avvay from: concentric alignment With the tube. y

ll.V .Thel combination with an endoscopic tube, of a plurality of independent si'ght'dejvices associated .therewith inyan'ianner which permits simultaneous observation intoK the tube through each thereof, one ofsaid def.- vices comprisinga telescope spaced from the tube end and adjustable into a plurality of positions wherein its aXis Vis substantially parallel to that ol' the tube.

12. The combination With an endoscopicv tube, of a telescope spaced from the tube end and adjustable relative to the aXis of the tube, said telescope being of a structural nature which permits desired observation therethrough in a number ot adjusted positions,

whereby the tube opening may be rendered freely accessible for normal utilization, during said observation, of operating instruments. f

13. The combination With an endoscopic tube, of a plurality of independent sight devices associated therewith in a manner which permits simultaneous observation into the tube 'through each thereof, one of said devices comprising a telescope spaced from the tube, and another otsaiddevices comprising a tubular element having an end thereoitI interposed-v into the space-j between the telescopey and.l the tube. v of i` 14. As a removable attachment for an endoscopic tube, a unitcoinprising a pluralityl of independentsight devices so constructed and arranged as to permit simultaneous observation through each thereof o' the tube interior, and to` also permit normal utilization ot og-l erating instrunientalities Within the tube, when the unit i's attached.

l5. hs a removable attachment for an endoscopic tube havingfan open end tor the passage ofcperating instruments, a unit comprising an attaching portion, and a sight device associ ated with said portion and so constructed and arranged with respect to said portion that when .the unit is attached the tube end will remain accessible for normal utilization Voll operating instruments.

16. As a removable attachment for an endoscopic tube having an open end for the passage of operating' instruments, a unit comprising an attaching portion, and a sight device associated with said portion and -so constructed and arranged with respect to said portion that when the unit is attached the tube end will remain accessible Vfor normal utilization of operating instruments, said device comprising an unbent tubular element having an eyepiece end and a light-receiving end, the latter end having aportion thereof projecting only partially into the path of the light rays emerging from the tube. -4 l i 17. ln a device of' the character described, an endoscopic tube having an open end for the passage of an operating instrument through may the tube, and means for permitting any operasaid open end,` and optical means associated tor to look through the tube during the-emwith said inner end for receiving the iight pioyment of said instrument, said means comrays emanating from said open end and trans- 10 prising a sight device arranged in its entirety i mitting them through said device.

5 exteriorly of the tube and behind said open Y In Witness Whereoil'have signed this speciend, said sight device having a light-receiving fication this 28th day of Oet., 1926. inner end which extends very slightly across A .y REINHOLD H. WAPPLER. 

